A Family Doctor's Tale - CEREBRAL PALSY

DOC I HAVE CEREBRAL PALSY

Cerebral palsy refers to a group of disorders characterized by loss of motor functions or any other nerve functions that appear in infancy or early childhood and permanently affect body movement and muscle coordination but don't worsen over time.

Even though cerebral palsy affects muscle movement, it isn't caused by problems in the muscles or nerves. These disorders are caused by brain damage that occurs during foetal development or near the time of birth.

The majority of children with cerebral palsy are born with it, although it may not be detected until months or years later.

Cerebral Palsy is mainly caused by brain damage that occurs during foetal development.

A small number of children have cerebral palsy as the result of brain damage in the first few months or years of life:
1. brain infections such as bacterial meningitis or viral encephalitis

2. head injury from a motor vehicle accident, a fall, or child abuse.

It is not an inherited disease.

Symptoms of cerebral palsy are:
The early signs of cerebral palsy usually appear before a child reaches 3 years of age. Babies with Cerebral Palsy are usually slow to reach developmental milestones.

Abilities like learning to roll over, sit, crawl, smile or walk are not well developed.
The motor abilities will often seem unusual and strange.

The most common are:
1.lack of muscle coordination when performing voluntary movements (ataxia);

2.stiff or tight muscles and exaggerated reflexes (spasticity);

3.walking with one foot or leg dragging;

4.walking on the toes,

5.crouched gait, or a "scissored" gait:

6.muscle tone that is either too stiff or too floppy.

The symptoms of Cerebral Palsy vary from just mild clumsiness to extensive uncontrolled muscle spasticity.

Many with cerebral palsy have other disabilities :
1.seizures,

2.an inability to see, hear, speak or learn as others do,

3.psychological or behavioral problems.

Not everyone with Cerebral Palsy is retarded. Some are of average intelligence.
While some people with Cerebral Palsy have learning disabilities many others do not.

There are four types of Cerebral Palsy:
1.Spastic Cerebral Palsy, the most common type, is a disorder in which certain muscles are stiff and weak.

2.Athetoid (dyskinetic, hypotonic, dystonia) Cerebral Palsy where involuntary movements are present.

3.Ataxic Cerebral Palsy occurs when the Cerebellum has been damaged, thus causing lack of coordination and jerky movements. This form of Cerebral Palsy have staggered or fragmented movements often involving tremors or exaggerated posturing (athetosis) and bizarre twisting motions.

4.Mixed Cerebral Palsy is when two or more types of cerebral palsy are present in the same person.

Cerebral Palsy is a lifelong condition that cannot be cured.


The treatment is aimed at maintaining or improving the quality of life, providing the sufferer with tools to enjoy a near-normal life.

There are basically three types of treatment for Cerebral Palsy:
1.Surgery can be used to correct muscle contractures - removal of tight contractures that inhibits proper movement of the limbs.

2.Drugs such as clonazepam, baclofen and dantrolene are sometimes used to control muscle spasticity. Anticholinergic medications can help to control abnormal movements.

Alcohol or botulinum toxin type A (Botox) injections into muscle may be used to reduce spasticity for a short time so health care providers can work to lengthen a muscle.
 
3.Adjunctive therapies include
a.Physiotherapy, the most common treatment for cerebral palsy, consists of special exercises designed to increase and improve the range of movement and strength of the muscle groups, is aimed at strengthening and stretching muscles and preventing spasticity as well as increasing muscle control.

b.Occupational therapy is designed to help the child develop the fine motor skills needed to function day-to-day at home and school.

c.Speech therapy will also help the child develop communication skills.

Cerebral palsy doesn't always cause profound disabilities.

A child with severe cerebral palsy might be unable to walk and need extensive, lifelong care.

Another with mild cerebral palsy might be only slightly awkward and require no special assistance.

Supportive treatments, medications, and surgery can help many individuals improve their motor skills and ability to communicate with the world.